EVENING. Health.

Leprosy Center Closing

March 05, 1999|By Barry Shlachter, Ft. Worth Star-Telegram.

The gate is open now in Carville, La. Residents come and go as they please.

But there was a time there when snatches of freedom--to catch a ballgame or make a phone call--meant slipping through a hole in the fence and risking 30 days in a lockup--60 days for the second offense.

Within the 330 acres bounded by barbed wire, generations of residents printed a magazine, earned Boy Scout merit badges, produced plays, held their own Mardi Gras, wrote books, fell in love and conceived children they were forbidden to raise.

Most are elderly now, the last 73 patients of the only long-term care center in the continental U.S. for Hansen's disease, known as leprosy. In 1951, its peak year, the Carville complex housed 480.

The federal government intends to close the Gillis W. Long Hansen's Disease Center in three years, turning out those who remain. Last year, 45 residents accepted $33,000 annual "stipends"--double for married couples--and moved away. The site will be handed back to Louisiana, whose National Guard will run a job-training boot camp for at-risk youths.

At Carville, all are cured but many continue to suffer from the physical damage--facial deformities, clawed hands and circulation problems--incurred before effective treatment was discovered. Then there are old-age infirmities and a psychological dependency nurtured by decades of institutionalization.

"It was a world of its own," said Texas-born Johnny Harmon, 87, who came to Carville as a young man for two lengthy stays and finally returned in 1992 with his wife, Anne, whom he met and married when both were patients. She arrived at age 10 after neighbors burned her family's home, he said.

"I wouldn't have come voluntarily, but I lived a fuller life than if I hadn't," said Harmon. Easily Carville's least shy resident, he tools around in a motorized wheelchair with a large hand-lettered sign affixed to the back, advertising his 184-page, self-published memoir, now in its fourth printing.

"It's kind of lonesome around here now," Harmon said of the departure of more than a third of the residents between August and late October.

Like others who stayed, he adamantly opposes leaving--even with a generous and tax-free living allowance of $33,000.

"I don't like it," snapped Harmon, once a draftsman with the Texas highway department who became a professional photographer at Carville. "It's really depressing. They'll have to take me out in a box."

For those who don't take the offer, assisted-living quarters are expected to be found in Baton Rouge, 26 miles to the north, where the Carville complex will eventually relocate as a scaled-back clinic, said Julia Elwood, its spokeswoman.

Elwood arrived as a frightened 16-year-old patient from the small South Texas town of Elsa. After being cured through a series of sulfone drug injections, graduating college and teaching school, she returned as a staff member, the first to do so.

None of the residents carries leprosy bacteria, whose mode of transmission still perplexes researchers. It is not a venereal disease, but specialists believe--but cannot prove--it spreads through skin-to-skin contact, inhalation of bacteria-containing droplets and, in some Southern states, handling armadillos.

However it's transmitted, it's done so with difficulty. Ninety to 95 percent of people are naturally immune. (Only one Carville employee ever contracted the disease, a powerhouse worker who did not come in contact with patients.) The international medical community recognized in 1956 that there no longer was any need to quarantine patients.

Today, less than two weeks' outpatient treatment with a cocktail of antibiotics removes the threat of contagion.

Although leprosy sounds like something out of antiquity, there are 690,000 new cases a year around the world. It is now called Hansen's disease--after the Norwegian scientist who discovered the rod-shaped bacterium--to differentiate it from the vague but damning biblical references to leprosy as a divine curse on the sinful and unclean.

Even after a cure was discovered in the mid-1940s by Carville researchers, the social stigma endured.

For years, patients were encouraged to take assumed names to spare their families embarrassment and ostracism back home.

Even after forcible detention ended in 1957, they built their own society and, at times, an aggressive cohesiveness. They successfully campaigned to oust one unpopular director and tried to push out another.

Today, as far as Washington is concerned, Carville has outlived its usefulness. There is no medical need to keep treated patients apart from society. And the $15.6 million annual budget has made it a costly white elephant to some.